I would like a second opinion. I am considering Vaser Lipo, is it safer over CoolSculpting? (Photos)

Question

Hello, I had a consult with my trusted board certified PS. I am not wanting a tummy tuck. I was thinking lipo because it shows more results than CoolSculpting. Doctor advised Vaser for hips and outer thighs but  not my stomach-3 kids and laxity and would require a TT.  How many inches can I loose? Any skin discoloration? I'm fair skin and I also get Varicose Veins and do not want to make worse and get treatment annually. I was told pain is about 10 days.  In my 50's. Thank you . :)

George Marosan, MD · Answer

Thank you for your question and photos. VASER liposuction and CoolSculpting are different procedures with vastly different results. VASER lipo is third generation ultrasound with liposuction and CoolSculpting is non-surgical fat freezing that causes mass fat necrosis. In my practice over 60% of my patients are seeking help for poor or suboptimal outcomes from their surgeons' liposuction outcomes. Of these, 25% also had CoolSculpting with minimal to no results. Unfortunately, CoolSculpting created very dense internal scarring, and none of these patients I could do without using the VASER liposuction technique. If you were my patient, I would do VASER Hi Def Lipo 360 degrees for maximum skin tightening and creation of an hourglass figure. You did not include any back photos, but judging from the abdomen, you do have significant fat on the back too. The thighs are not possible to evaluate from these limited view photos.
See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. It seems that your trusted board certified PS even though he/she owns a VASER is not familiar with total body reshaping. Using spotty or limited area treatments gives inferior results to liposuction 360 degrees. Good luck.

Jason Emer, MD · Answer

it looks like you have loose skin and may need skin removal or at least internal heating.

my whole practice is doing lipoabdominoplasty, or at least liposuction with internal heating (which is not the gold standard for skin tightening with body contouring).

the smaller you are before liposuction the more contouring you can get from the procedure. most of my liposuction patients get pre and post surgical optimization with hormonal therapy (see link to help boost their weight loss before surgery and help them heal after).

You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Darryl J. Blinski, MD · Answer

Any type of liposuction so superior to non surgical COOLSCULPTING! You should try lipo on all areas first. CoolSculpt is a total waste of time and $$s. As for doing full TT I think you could achieve a great result from lipo only if done in a true expert lipo surgeon.

Arian Mowlavi, MD, FACS (license on probation) · Answer

VASER Lipo is a minimally invasive body-contouring procedure, melting the unwanted fat in your body, using ultrasound technology. The Gold Standard for superior liposuction results requires use of the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

I think your surgeon is correct about getting a tummy tuck. There are four variables we look at making an abdominal assessment.

These are skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies and excess visceral or intra-abdominal fat.

My best guess is you have all four of them in equal amounts.

A tummy tuck primarily treats skin laxity and muscle separation but also by stretching the skin thins out the subcutaneous fat layer on the front of the abdomen.

Weight loss will improve the results and weight loss before your procedure will make you a better candidate.

Liposuction on the lower extremities especially in older patients with skin laxity often gives results far less than patience and hope for.

This is especially true in the upper inner thigh.

It’s also true on the back half of the outer thigh.

True saddlebags on the outer or outer front part of The thigh typically respond very well.

In regards to your abdomen or your torso well done Liposuction is the quintessential correct procedure.

Recovery typically takes two weeks and you should expect the first three days to be severely intense.

I would encourage patient to consider spending the first 24 hours having a full-time nurse like in a recovery suite.

Best,

Mats Hagstrom MD

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